Strong association between oral and non-communicable diseases: Tackle the common risk factors

Brenda Lau, 03 Aug 2016

Poor oral health may cause or complicate non-communicable diseases

Statistical trends point to a strong association between oral diseases and four main non-communicable disesases (NCD) - diabetes, cancer, cardiovascular diseases and respiratory diseases.

Deputy Health Minister Dr. Hilmi Yahaya said based on the National Health and Morbidity Survey (NHMS) 201, most of the NCDs risk factors among the adult population in Malaysia are on the upward trend compared to the previous year.

A research by WHO has stated that oral diseases such as dental caries, periodontal disease, tooth loss, oral mucosal lesions and oropharyngeal cancers, HIV/AIDS-related oral disease and orodental trauma are major public health problems worldwide and poor oral health has a profound effect on general health and quality of life.

The association between oral diseases and non-communicable diseases

The important role of sociobehavioural and environmental factors in oral health and disease has been shown in a large number of socioepidemiological surveys.

Unhealthy lifestyles such as poor diet, nutrition and oral hygiene as well as use of tobacco and alcohol contribute to oral diseases. These unhealthy lifestyles also contribute to NCDs such as diabetes, cancer, cardiovascular diseases and respiratory diseases, therefore the common risk factors form a strong association.

Oral diseases may also complicate or even cause NCDs and cause other general health problems. Gum disease can complicate diabetes, increase risk of low-birthweight and pre-term babies, increase risk of cardiovascular disease and be the starting point of noma.

The mouth may be a reservoir for bacteria associated with stomach ulcers and dental infections have also been associated with higher increased risk for pneumonia. On the other hand, oral bacteria are associated with infective endocarditis (inflammation of the heart’s inner lining) and infective athritis.

Therefore, tackling the common risk factors such as tobacco use, high sugar intake, and lack of physical activity will reduce the burden of a number of high-impact diseases.

Tackling common risk factors of oral health and non-communicable diseases

There is a direct link between the quantity and frequency of sugar consumption and increased risk for tooth decay, type 2 diabetes and obesity. Bacteria in the mouth metabolise sugars into lactic acid which causes decay of teeth through demineralisation over time.

Tobacco use in all forms - be it smoked, sucked, chewed or snuffed - is dangerous for overall health and a risk factor for oral diseases. It can lead to oral cancers, especially in combination with high alcohol consumption, and periodontal diseases.

Smoking during pregnancy can also lead to congenital defects such as cleft lip and palate in children with long-term effects either from treatment or deformation. It affects the quality of daily life in many ways including bad breath (halitosis) and staining, decreased wound-healing, suppressed immune response to oral infection, promotion of gum disease in diabetics and has an adverse affect on the heart and lungs.

According to statistics from the World Dental Health Federation, more than 80% of 6-19 year olds have dental decay.

"It is very worrying when more than half of the population with diabetes and hypertension and 80 per cent of individuals with high blood cholesterol level are unaware of their health conditions.

"Local and global NCD initiatives are now gaining momentum in addressing the determinants of NCDs, among these are the reduction of sugars and tobacco which potentially can reduce oral diseases," he said in his opening speech at the Malaysia-International Dental Exhibition and Conference (MIDEC) 2016.

His text of speech was read out by Health deputy director-general Datuk Dr Lokman Hakim Sulaiman.

MIDEC 2016 is a four-day conference aimed to provide opportunities for global networking and fostering friendships within the worldwide dental fraternity.

WHO has also called for worldwide strengthening of public health programmes through the implementation of effective measures for the prevention of oral diseases and promotion of oral health urgently . The challenges of improving oral health are particularly great in developing countries.

At the recent Malaysian Community Pharmacy Business Forum (MyCPBF), a discussion forum was held on the subject of “Transcending Primary Healthcare Services: The Future of Specialized Pharmacy Services and Pharmacy Specialization”.